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[Supraventricular tachycardias induced by swallowing]
Annales De Medecine Interne
|January 1, 1983
Summary
Swallowing can trigger dangerous heart rhythm problems like atrial tachycardia. This case reveals a rare instance of swallowing-induced supraventricular tachycardia linked to a specific heart pathway.
Area of Science:
- Cardiology
- Electrophysiology
- Gastroenterology
Background:
- Supraventricular tachycardia (SVT) can be triggered by various stimuli.
- Swallowing-induced SVT is a rare phenomenon with debated mechanisms.
Observation:
- A 34-year-old woman experienced recurrent, poorly tolerated junctional tachycardia (260 bpm) exclusively induced by swallowing.
- The arrhythmia could be voluntarily reproduced and required significant amiodarone for electrophysiological study.
- No significant cardiac or gastrointestinal disease was identified, apart from a history of thromboembolism.
Findings:
- Electrophysiological studies identified a rapidly conducting, exclusively retrograde paranodal accessory pathway.
- This pathway was responsible for triggering reentrant tachycardia episodes.
- The findings suggest a specific anatomical substrate for swallowing-induced SVT in this patient.
Implications:
- This case highlights a rare but significant cause of drug-refractory SVT.
- Understanding the link between swallowing and SVT can aid diagnosis and management.
- Potential mechanisms include mechanical stimulation and autonomic nervous system changes, warranting further investigation.